Helping Hands Hospital

(0845 Sunday 4/11/10)

Namaste!

Sorry for the delay in updating you, we have been busy! I believe I left off after yoga on Friday morning, which btw, we are doing daily, and personally I think it is really helping with our focus. So lovely up there in the mornings. This morning was clear and blue and breezy, and altogether fabulous. Jason brought his TRX personal training system (as seen on TV, from personal training legend Todd Durkin…), and we had 2 sessions going today, me doing yoga on one side, and Jason doing strength training on the other. Where was everyone else, I wonder? Up late partying, I am sure. ☺

Before I get into what we’ve been doing for 2 days, I will inform you (ie Pete’s family and friends) that Pete was the first to fall. So if any of you others had money on Melissa, I’m sorry for your loss, and my lousy tip. That chick has an iron GI tract: she’s been eating grapes off the ground, raw meat from street-side vendors, drinking water from the tap, and no issues at all! Poor Pete had a Fanta from the local grocery store and just now emerged from his room after 30 hours of purging alien substances from multiple orifices. I wanted to make sure not to mention how sick he was until he was all better, so as not to worry the family too much. This morning he looks wonderful - great color, smiling, nibbling on saltines and daintily sipping Tang. Just another day in Nepal! We’ll see….who’s next?

Friday was spent at Helping Hands Hospital, where we had an extensive tour by Dr. Gupta, the hospital Director. I am so impressed by all the improvements since I was here six months ago. They are expanding the emergency room to double the size of the space and number of beds, which should be finished next week. The new ICU is almost finished, only needs to have the equipment and beds moved in. They have added a histopathology lab, which is something that almost no hospitals have here in Kathmandu; usually they have to send everything out, often to India. The pathologist here has a telemedicine set-up, and is able to sent photos of tissue to consult other pathologists on difficult cases. She was very interested to know if there would be any interest at Christiana Care in creating a relationship for consultations such as this. If there are any pathologists reading this, I’m going to be calling you when I get home. You can save some time by just emailing me now. ☺

There have been numerous additions to the lab equipment, and therefore the diagnostic capabilities have increased significantly. We spent some time with the interventional radiologist, who performs all echocardiography, stress echo, ultrasound, endoscopy and colonoscopy. He is very excited to work alongside the doctors from our team in the ultrasound department, to trade knowledge and skills. He inquired as to whether we are planning to come back any time soon and put on a multiple-day conference focusing only on ultrasound use for emergency medicine… I said that sounds like a great idea (I was already thinking that…). Anyone interested, you know where to reach me. (Paul and Jason, clear your schedules in the fall for a week or two…) I know that there are one or two other programs in the US that do periodic ultrasound teaching here in Kathmandu, however there apparently has never been a full conference on EMUS that is open to all comers. At Tribhuvan Teaching Hospital, there is an ultrasound in the ED, locked in a wooden cabinet, because no one knows how to use it. Just sitting there! There would be a patient sitting next to that cabinet on a gurney, a pregnant woman after a car accident who has abdominal pain and vaginal bleeding, and she waits hours to go to the radiology department to get a full US, all the while she could have been evaluated immediately if the physicians had the skills to use the US. Think about that…

After an exhausting day at the hospital, it was back to Thamel for some rest and regrouping. All of us needed to work on preparations for the upcoming conference, so there was a lot of key clicking and cursing at the wifi in the evening. I think the gals (sorry, the doctors…) are making great progress, and they are working hard on their presentations. I know I have already said this, but I am impressed with their dedication to making this conference, and their roles in it, successful. I hope they know how much good they are doing for so many people.

We all walked about 20 minutes through town to an outside garden-type restaurant for dinner, which was quite lovely, although the loud sound of the generator made it a little difficult to chat much. After 20 minutes or so, the power came back on and the generator turned off, ahhh! Many of the restaurants here that are considered “local” or “traditional cuisine” serve mostly Nepali food and Indian food, with an occasional smattering of Chinese food. Nepali food is really not that complicated; dahl (lentils), bhat (rice) and potatoes, usually with spinach and a meat choice if you want. There’s not much variation on that, it’s just vegetarian Nepali food or non-veg Nepali food. It’s awesome, btw. Indian food, however, has lots of options, and is quite delicious here. Be aware, though, as no one asks whether or not you want things spicy or mild, and if you don’t say so, they assume it’s spicy. Not great for wimpy little taste buds like mine, although not a problem for “iron stomach” Melissa. I think she can eat rocks.

This point in time, however, was the start of Pete’s downward spiral, so some of us left early to get him into his room near a bucket. It had been a long day, and I personally passed out at that point. There’s something wonderful about being in a place where there’s not that much to do after dark, and once the sun is coming up everything begins. I am the farthest thing from a morning person usually, but here I am up at 0500, ready to seize the day, and by 9pm, out like a light. No Project Runway, no Daily Show, no nothing. I heard a rumor that someone in our group has some DVD’s, specifically Star Wars, which may be tempting enough to have a late movie night one of these days. Maybe we’ll wait until we’re in the middle of nowhere in the rural village of Wana, as activities there will be even more scarce. The real show in Wana will be the stars, hundreds of thousands of them so bright at night, we’ll never be bored. I am so looking forward to it.

More soon!

Sue/Team

Radiologist performing liver ultrasound


EKG - see the suction cups!


Entrance to the Emergency Room (under construction)